A rare cause of acute abdominal pain: Torsion of wandering spleen

Abstract

Wandering spleen is a rare condition presenting as the spleen being found somewhere different from its usual location due to the looseness of the peritoneal ligaments of the spleen. Its occurrence rate among the major splenectomy series in medical literature is less than 0.5%. It usually presents itself between the ages of 20 and 40 and the majority of the patients are women. A 20-yearold female patient with recurrent abdominal pain was admitted to our emergency clinic with abdominal pain going on for 3 days, nausea, vomiting and loss of appetite. Computerised Tomography (CT) indicated a pelvis localised spleen and an infarctus due to a non-homogenous parenchyma area. The patient was operated on with a provisional diagnosis of wandering spleen. During exploration a relatively large, congested and mobile spleen was found in the pelvis and a splenectomy was performed. The wandering spleen presents itself on a spectrum ranging from asymptomatic to acute abdomen. Symptoms usually arise from complications related to torsion. The surgical methods performed on wandering spleen are splenorraphy and splenectomy. The deciding factor for determining the treatment method is the existence of infarction in spleen. Wandering spleen is very rare and a cause for acute abdominal pain, we think it is important to consider it for differential diagnosis in cases with acuteabdominal pain, especially the cases with intra-abdominal mass findings, for an accurate diagnosis and treatment plan.